Amnesty International says U.S. maternal death rate is human rights crisis

Women in the U.S. have a higher risk of dying of pregnancy-related complications than women in 40 other countries, according to a recent report from Amnesty International. That's despite the U.S. spending more than any other country on health care and more on maternal health than other types of hospital care.

The mortality ratio rose to 13.3 deaths per 100,000 live births in 2006, from 6.6 deaths per 100,000 live births in 1987.

This is not just a public health emergency – it is a human rights crisis. Women in the USA face a range of obstacles in obtaining the services they need. The health care system suffers from multiple failures: discrimination; financial, bureaucratic and language barriers to care; lack of information about maternal care and family planning options; lack of active participation in care decisions; inadequate staffing and quality protocols; and a lack of accountability and oversight.

"I think [the report] is probably surprising to the American population because we have a reputation of having one of best health care systems in the world," Dr. Linda Burke-Galloway, an OB-GYN in Central Florida and author of The Smart Mothers Guide to a Better Pregnancy, said in an interview. "The problem is when people hear about maternal mortality, they often view it from the perspective of third-world countries."

The eye-opening report says minority women are more at risk of dying or having complications during pregnancy than white women. Native American and Alaska Native women are 3.6 times as likely as white women to receive late or no prenatal care, while African American women are 2.6 times as likely and Latina women are 2.5 times as likely.

African-American women also are four times more likely to die in pregnancy than white women. "I was so impressed that they came to the conclusion that you have to treat African-American women specifically as a high-risk pregnancy. I agree with that. Our issues are different."

She added: "I think that part of the problem is cultural incompetence in terms of the people who take care of women of color. Every minority has their own set of problems. ... I worked on a Native American reservation ... It's access to care. No one wants to go to a remote community to deliver babies, so they're under the management of midwives without an attending physicians. ... There are more women who die on those reservations than will even be reported."

The Amnesty report details many cases of women who did not receive the care they needed because of a language barrier or lack of insurance. Nearly 13 million women aged 15 to 44 do not have insurance. For women who are uninsured, eligibility for Medicaid can be denied without a letter from a doctor confirming a pregnancy.

According to the report, "a homeless woman violated the terms of her probation in order to be taken into custody, when she was nearly eight months pregnant, because she was desperate to get health care and shelter. Her friend told Amnesty International that she "turned herself in...just so she could get some care for her child, to have her kid."

There's also a lack of accountability on the part of medical staff. "There are no federal requirements to report maternal deaths, and the authorities concede that the number of maternal deaths may be twice as high," the report states. "Reporting of pregnancy-related deaths as a distinct category is mandatory in only six states and despite voluntary efforts in some other states, systematic under counting of pregnancy-related deaths persists."

Amnesty International is calling on the Secretary of Health and Human Services to create an Office of Maternal Health to make sure all women have adequate prenatal health care. The organization has a letter at its website that you can copy and send to the Department of Health and Human Services if this is an issue you are concerned about.